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14 Significance of Perceived Racism: Toward Understanding Ethnic Group Disparities in Health, the Later Years
Pages 540-566

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From page 540...
... , the observation of poorer health profiles for black males and females tended to persist, even after stratifying by socioeconomic status. Among the other ethnic groups, non-Hispanic whites generally had the second poorest profiles, with Hispanics having the most favorable profiles and Asians or Pacific Islanders and Native Americans having intermediary profiles.
From page 541...
... Recent research suggests that behavioral risk profiles (NCHS, 1998) as well as direct and indirect effects of environmental and sociopolitical conditions are among the factors that contribute to these health disparities (Smith, Shipley, and Rose, 1990; Tennstedt and Chang, 1998)
From page 542...
... blacks once endorsed the idea of lighter skinned superiority (Gatewood, 1988; Okazawa-Rey, Robinson, and Ward, 1986) and routinely blocked darker skinned blacks from valued resources (e.g., matriculation at select historically black colleges and universities, as well as membership in some predominantly black fraternities and sororities, churches, and social/business organizations)
From page 543...
... and physiological (e.g., sympa Sociodemographic and economic factors Perceived racism Constitutional Psychological and Coping factors physiological responses Allostatic load Health status Institutional racism FIGURE 14-1 Conceptual model to examine the contribution of racism to health disparities.
From page 544...
... Once the stimulus is perceived as involving racism and involving harm, a threat, or a challenge, psychological and physiological stress responses will result, followed by coping responses. Over time, the repeated activation and adaptation of these psychological and physiological systems are posited to lead to an allostatic burden, which, in turn, increases the risk of negative health outcomes (McEwen and Seeman, 1999)
From page 545...
... Were these findings to be replicated among persons in the later years, and were the cumulative psychological and physiological effects of perceived racism associated with coping resources and allostatic burden, a more informed understanding of probable contributors to the health divide in the later years might be evinced. Socioeconomic Status Research indicates that socioeconomic status (SES)
From page 546...
... . To the extent that the magnitude of psychological and physiological stress responses are similar for overt and more subtle forms of perceived racism, contributing to comparable allostatic burdens, the deleterious effects of perceived racism would be observed across SES groups among those disproportionately exposed to environmental stimuli perceived as involving racism and involving harm, a threat, or a challenge.
From page 547...
... ") , recent discrimination (same as lifetime discrimination questions, except exposure is limited to the past 12 months)
From page 548...
... Therefore, it is possible that whites were reporting on experiences of discrimination that they perceived as being secondary to their gender, sexual orientation, SES, or weight. Although the discrimination scores for blacks probably were also inflated with respect to perceived ethnic discrimination -- as opposed to discrimination from all causes -- research indicates that blacks overwhelmingly attribute such unfair treatment to racism, whereas whites do not (Williams et al., 1997b)
From page 549...
... Their findings indicated that the stress associated with perceptions of institutional and collective racism was significantly higher for black males relative to black females. These findings, coupled with the previously mentioned observations that blacks perceive more racism than whites, suggest that black males may be the most vulnerable to the allostatic burden associated with perceived racism -- a pattern that mirrors the health risk profiles of black males (highest risk)
From page 550...
... and is nonexistent among the elderly, a limited number of studies using youngand middle-adulthood samples have examined the relationship of perceived racism to resting blood pressure and cardiovascular responses. These studies have shown that perceptions of racism are positively related to stressinduced changes in diastolic blood pressure in blacks (Fang and Myers, 2001; Guyll, Matthews, and Bromberger, 2001)
From page 551...
... FIGURE 14-3 Absolute diastolic blood pressure levels for participants scoring in the upper and lower quartiles on perceived racism measure. SOURCE: Clark (2000)
From page 552...
... For example, in a sample of black college females, Clark and Anderson (2001) found that although some passive and active coping responses were positively related to blood pressure and heart rate responses, both strategies were also inversely related to cardiovascular responses.
From page 553...
... Institutional Racism Even when racism is not perceived, institutional forms of racism may also influence health directly by restricted access to health care or highquality health care (King, 1996; Kuno and Rothbard, 2002; Sheifer, Escarce, and Schulman, 2000; Whaley, 1998; Williams, 1997)
From page 554...
... . To the extent that acute perceptions of racism are associated with increased neuroendocrine responses and excitatory amino acid neurotransmitter activity, resulting in reduced hippocampal volume, chronic perceptions of racism might be related to cognitive deficits in the later years among those who are disproportionately exposed (McEwen, 2000; Seeman, Singer, Rowe, Horwitz, and McEwen, 1997)
From page 555...
... . Although perceptions of interethnic group racism and intraethnic group racism are important considerations, the extent to which racism interacts with acculturation to influence the psychological and physiological risk profiles of black elders would probably lead to a more informed understanding of the complex interplay between racism and cultural factors.
From page 556...
... For example, some persons who perceive stimuli as involving racism probably do so because it is less anxiety provoking than attributing the failure of being promoted at work to personal deficits. Furthermore, some persons who do not report perceiving racism probably fail to do so because of denial or as an attempt to avoid the expected psychological distress that would be associated with negotiating an uncontrollable stressor.
From page 557...
... For example, if cross-sectional research indicates that the perceptual base rates of racism (peak in middle adulthood and presumably the allostatic burden associated with these perceptions) , targeted longitudinal research could be initiated during this period to explore concomitant changes in psychological and physiological systems.
From page 558...
... advised against the use of standard screening tools to assess cognitive functioning in elderly blacks. She reasoned that because cognitive functioning determines the course of various treatments for older adults, and black elders more than any other age cohort have been systematically deprived of access to quality education, the continued use of standard cognitive batteries, which are more likely to incorrectly label those whose education level does not exceed the seventh grade as being mildly demented, would perpetuate the untoward effects of institutional racism.
From page 559...
... . Relationship of racial stressors to blood pressure responses and anger expression in black college stu dents.
From page 560...
... . Moderating effects of perceived racism on John Henryism and blood pressure reactivity in Black college females.
From page 561...
... . Skin colour, measures of socioeconomic status, and blood pressure among blacks in Erie County, NY.
From page 562...
... . The association of skin color with blood pressure in U.S.
From page 563...
... . Racial discrimination and blood pressure: The CARDIA Study of young black and white adults.
From page 564...
... . Relationship between skin color and blood pressure in Egyptian adults: Results from the National Hypertension Project.
From page 565...
... American Journal of Kidney Diseases, 19, 414-419. Sterling, P., and Eyer, J
From page 566...
... . Racial differences in physical and mental health: Socioeconomic status, stress and discrimination.


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